| Organization Name: | WILDER LANGUAGE AND LEARNING |
| NPI Number: | 1598189086 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LARISA M WILDER (OWNER/ SPEECH LANGUAGE PATH) |
| Mailing Address: | 3825 Monterey Place Boulder |
| State: | CO US |
| Postal Code: | 80301 |
| Phone Number: | 3038180508 |
| Fax Number: | |
| NPI Enumeration Date: | 02/05/2014 |
| NPI Last Update Date: | 02/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 12119008 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |